rx: Fresh food

​ Fresh Food by PrescriptionNational Public Radio (NPR) ran a story with this headline on May 8, a bit unusual for a progressive news outlet usually promoting the wonders of science and the benefits of pharmaceuticals. Hearing that there is something “natural” that actually may benefit us rather than harm us is reassuring.

The story begins by acknowledging Hippocrates’ prescription from about 2400 years ago, “Let food be thy medicine.” (I suppose there was an old Greek version of “your” just like our old English “thy.”) The story then goes on to say that about half of the deaths “from heart disease, stroke, and Type 2 diabetes in the U.S. is linked to a poor diet. That's about 1,000 deaths a day.” We know that the treatment of Type 2 diabetes with insulin does not lead to recovery from diabetes; the insulin only helps a person to survive with diabetes. The story points out the tremendous success in reducing the A1C scores of patients using food therapy. A drop from double digits to near the type 2 diabetes threshold of 6.5 is very significant. (The A1C shows the average level of blood sugar over the last 90 days rather than the blood sugar at a particular point in time shown by the blood glucose test.)​ Patients are sent to the Geisinger Fresh Food Pharmacy. Foods there include whole grains, beans, fresh produce, greens, low fat dairy, lean meats, and fish. A dietician gives instructions for food preparation and the patient takes home a 5-day supply of free food.The idea of giving free food may sound either altruistic or crazy, but economics is high on the motive list. The article quotes the cost of treating diabetics in the U.S. at over $240 billion per year. A drop of 1 point in the A1C saves the insurer about $8,000 a year per patient, so the $1,000 of free food leaves a pretty hefty net gain. Not only are the economics sound, but the quality and quantity of life of the Type 2 diabetic also increases dramatically.Note that a $240 billion business will not quietly slip out of the way while patients’ health improves. There are vested interests that will resist.

One of the ways that this improvement in health can be stalled is by keeping low income people from being able to afford a healthy diet. Note that the Geisinger Fresh Food Pharmacy is focused on getting a high quality diet to those who can least afford it. The government will pay for medical services and insulin and other drugs. They will not pay for healthy food. We see this in the agricultural products that are subsidized: wheat, corn, soybeans, rice, and cotton. Subsidizing calories is said to go back to Richard Nixon and his instruction to Secretary of Agriculture Butz not to let the price of food be a political issue. The result was a shift toward promotion of large monocultures that were economical to produce. Nutrition was not a relevant concern. Federal money primarily goes to large farms using intense chemical application that damages the environment (and people), and produces food that has less nutrition. Cheap calories are our low nutrition processed foods. They give the appearance of food but are more like an imitation of food. Good health has never been associated with the American low cost cuisine.​ Diet matters. And you cannot exercise or medicate your way out of a bad diet. That, too, has been known for a long time.​ Next article